FTP6.3 In Hospital Delay to Laparoscopic Appendicectomy in CT Proven Appendicitis
Emily Farrow, Simon Phillips, Nitin Arvind- Surgery
Abstract
Aims
The ability to deliver emergency general surgery (EGS) is often limited by access to emergency theatres. The Royal College of Surgeons suggests that clinical audit of EGS activity will establish evidence that can contribute to service change. Laparoscopic appendicectomy is one of the most frequent EGS operations performed. The aim of this study is to quantify in hospital delay to theatre for CT proven appendicitis and examine clinical outcomes.
Methods
In a large major trauma and transplant centre, where emergency theatre space is shared with several specialties, data were collected on patients admitted with CT proven appendicitis over a 6-month period (01/06/2022 to 01/12/2022). Details of CT findings, intra-operative findings, as well as time of booking, operation and discharge were recorded.
Results
65 patients presented with CT proven appendicitis. The average time to theatre from time of booking was 16.7 hours. 60.0% (39/65) patients took >12 hours to get to theatre. Of these, 7.7% (3/39) had perforated appendicitis on CT. 33.3% (13/39) had perforated appendicitis at the time of surgery. The average stay of patients with perforated appendicitis at the time of surgery was 4.1 days longer than those with uncomplicated appendicitis.
Conclusions
In hospital delay of more than 12 hours has previously been shown to be an independent risk factor for perforation. A large proportion of our patients took more than 12 hours to get to theatre and those with perforated appendicitis had an increased length of stay. Delays in delivering EGS results in increased length of stay, exacerbating the bed crisis.